[Gas gangrene in urologic diseases. An example based on 3 case reports]. / Gasbrandinfektion bei urologischen Erkrankungen. Ein Beispiel an drei Fallbeschreibungen.

Gas gangrene is a rare infection of grave consequences. It is caused by obligatory anaerobic bacteria. Its appearance in urology is extremely rare. The infection can be acquired either from the outside or from enteral invasion of saprophytes, which are common in body cavities. Very often resistance-weak patients are attacked. In acute cases with typical signs of sepsis in addition to local signs of infection, a fatal outcome cannot be prevented in all cases despite adequate early therapy. Search for bacteria is mostly in vain. The 3 cases demonstrate that absolute asepsis and hygienic rules in simple manipulations (e.g. catheterizing as well as in major urologic operations are absolutely necessary. Traumatic lesions must be reduced to a minimum. Therapy must be started immediately.

[Palliative disconnection of the kidney by transcatheter arterial embolization (author's transl)]. / Paliative Funktionsausschaltung der Niere durch arterielle Katheterembolisation.

To eliminate urine production of one Kidney transcatheter embolization of the renal artery was performed in 11 patients with mallignant tumors in the area of the pelvis; in addition to the abave procedure in 9 patients a urinary; diversion by transrenal catheter and a ureteric ligation of the opposite side was also carried out. The therapy is of palliative character and signifies the smallest intervention possible to most treat effectively involuntary urination caused by urine fistulas, painful pollakisuria caused by shrinking bladders, and to treat painful hydronephrosis caused by tumors and the like.

[The catheterembolisation for permanent occlusion of the renal artery--anaesthesiologic views (author's transl)]. / Anaesthesiologische Gesichtspunkte bei der Katheter-Embolisation zur permanenten Occlusion der Nierenarterie.

Experiences with a new radiological technique, namely embolisation of the renal artery with a spiral from Gianturco, are reported. Continuous epidural block has been found to be the best method of anaesthetic management. The technique of embolisation was used in 17 patients. As a preoperative measure it facilitates tumournephrectomy, saves blood and reduces the danger of dissemination of tumour-cells during operation.

[The Gianturco method of spiral embolisation of the renal artery (author's transl)]. / Spiralembolisation der Nierenarterie nach Gianturco.

Spiral embolisation of a renal artery by the Gianturco method was carried out in eight patients. Our early experience with this technique is described. In seven patients it was possible to occlude arterial flow to the kidney completely, or almost completely. In one patient, faulty technique lead to an avoidable complication resulting in dislocation of the spiral into the femoral artery. The Gianturco method has advantages compared with other embolisation techniques, being simple, rapid, complete and permanent. In addition to its pre-operative and therapeutic use with renal tumours, the method can be used to abolish function in one or both kidneys.

[Transcatheter embolization of renal artery--alternative to preoperative renal tumour radiotherapy? (author's transl)]. / Katheterembolisation der Nierenarterie, eine Alternative zur präoperativen Radiotherapie bei Nierentumoren?

Transcatheter coil embolization (according to the method of Gianturco) was performed in 18 patients. It resulted in prompt and permanent occlusion of the renal artery without considerable effort and with acceptable risk. The favourable benefit of this procedure is technical facilitation of tumornephrectomy, cutting down the time of surgery, reducing intraoperative hemorrhage and danger of venous displacement of tumor-cells. The same favourable results will not be achieved by preoperative short-time radiation. Preoperative long-term radiation delays the necessary tumor-nephrectomy. Arterial embolization is preferred because it offers the wanted benefits of sufficient radiotherapy avoiding its disadvantages.